Hyperemesis Gravidarum Flashcards
(10 cards)
When does nausea & vomiting in pregnancy usually occur?
Starts from 4-7 weeks. Peaks at 10-12 weeks. Resolves by 16-20 weeks. Symptoms may persist throughout pregnancy.
What causes nausea & vomiting in pregnancy?
Placenta produces human chorionic gonadotropin (hCG) which causes it. Higher levels of hCG cause worse symptoms.
When is nausea & vomiting more severe?
In molar pregnancies and multiple pregnancies due to higher hCG levels. Worse in first pregnancy and in overweight or obese women.
How do you diagnose hyperemesis gravidarum?
Nausea & vomiting in pregnancy PLUS: 1. More than 5% weight loss compared to before pregnancy 2. Dehydration 3. Electrolyte imbalance
How do you assess the severity of hyperemesis gravidarum?
Pregnancy Unique Quantification of Emesis (PUQE) which gives a score out of 15: <7 = Mild, 7-12 = Moderate, > 12 = Severe.
What is the management for hyperemesis gravidarum?
Antiemetics: Prochlorperazine, Cyclizine, Ondansetron, Metoclopramide.
What can be used if acid reflux is a problem?
Ranitidine or omeprazole. Ginger. Acupressure on wrist at PC6 point.
How do you manage mild cases of hyperemesis gravidarum?
Oral anti-emetics at home.
When would you consider hospital admission for hyperemesis gravidarum?
Unable to tolerate oral antiemetics or keep down any fluids. More than 5% weight loss compared with pre-pregnancy. Ketones are present in urine dipstick (2+ on ketones). Other medical conditions need treating that required admission.
What would you give on admission for hyperemesis gravidarum?
IV or IM antiemetics. IV fluids - saline with added potassium chloride. Daily monitoring of U&Es while having IV therapy. Thiamine supplementation to prevent deficiency. Thromboprophylaxis - TED stockings and low molecular weight heparin during admission.
